ACUTE DISSEMINATED PULMONARY HISTOPLASMOSIS TREATED WITH CORTISONE AND MRD-112

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Abstract
A 32 year-old white male patient was exposed to a dust of bat manure while exploring a cave. The fungus Histoplasma capsulatum was subsequently isolated from the bat manure. Pulmonary symptoms appeared 3 weeks after exposure, gradually increased in severity, and were not affected by antibiotic therapy. The maximum symptoms appeared about the time the histoplasmin skin test became positive. Complement fixing antibodies for H. capsulatum were present in the serum in a titer of 1128. The lungs were filled with rales, dyspnea and cyanosis were severe and not materially relieved by treatment in an oxygen tent. The authors concluded that death was immanent from mechanical obstruction in the alveoli from the allergic reaction to the products of the fungus and decided to treat the patient with cortisone. The fungicidal drug, beta-di-ethyl-aminoethyl-fencholate (MRD-112) was administered in an effort to prevent a spread of the fungus. The improvement was dramatic. Cyanosis and dyspnea disappeared in 24 hours. He was removed from the oxygen tent in 3 days. There was progressive clearing of the lungs which became normal by X-ray in 6 months.